Katie M Dietz, LMP
Individual provider Active NPI Mechanotherapist · Post Falls, ID
NPI 1376819458 · NPPES record last updated Mar 22, 2012
Key facts
- NPI
- 1376819458
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mechanotherapist 172M00000X
- License
- MA60221323 (WA)
- Practice address
- 605 N Shetland CT
Post Falls, ID 83854-5447 - Phone
- (208) 215-8140
- NPI assigned
- Mar 22, 2012
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA60221323 | WA | MD | Mechanotherapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mechanotherapist | 172M00000X | MA60221323 | WA | Yes |
Addresses
Primary practice location
605 N Shetland CT
Post Falls, ID 83854-5447
Mailing address
605 N Shetland CT
Post Falls, ID 83854-5447
Phone (208) 215-8140
Other providers in Post Falls, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 22, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.